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Introduction: The large mixture of races in Brazil gives the nose its distinctive composition, which makes rhinoplasty difficult for these patients. Every patient should have their anatomy thoroughly examined on an individual basis, as there is no unique strategy that works for all situations., Methodology: This is a narrative overview of the last 10 years' worth of literature that describes the ethnic traits of each nose, with a particular emphasis on the Brazilian nose, and talks about the major surgical approaches that can be applied in these situations., Results: The low dorsum, broad nasal bones, thick skin, and bulbous tip are the primary features of the Brazilian nose. Many times, lateral osteotomies, root grafting, isotretinoin treatment for skin thickness, and neodomus formation are required., Conclusion: The Brazilian nose presents a surgical challenge that calls for the mastery of multiple procedures, not simply structured rhinoplasty. In certain cases, preservation rhinoplasty may even be used., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Background: Osteotomies are important maneuvers in the plastic surgeon's arsenal for the nasal dorsum treatment. However, there is a concern regarding a possible medialization of the inferior turbinate's heads and narrowing of the internal nasal valve if the Webster's triangle is not preserved., Objectives: To analyze the mobilization of the inferior turbinates during primary rhinoplasty after lateral osteotomies., Methods: This is a retrospective study in which we analyzed 37 patients who underwent very low-to-low osteotomies in our service, during primary rhinoplasties. Axial and coronal computed tomography scans were obtained, and preoperative and 6 months postoperative images were compared with Radiant DICOM Viewer software (Medixant, Poznan, Poland) in 3-dimensional multiplanar reconstruction., Results: There were no statistically significant differences between preoperative and postoperative measurements of the lower turbinate's osseous bases, both in axial ( P = .305) and coronal ( P = .08) images., Conclusions: Low-to-low osteotomies showed no medialization of the inferior turbinate's heads or narrowing of the internal nasal valve in this study., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society.)

Background: The most accurate methods for assessing fat grafted volume, such as computed tomography (CT) scan and magnetic resonance imaging, use 3-dimensional (3D) evaluation of the recipient area. Currently, other measurement techniques such as photogrammetry (compilation of photos) are employed., Objectives: The aim of the present study was to compare 3D images obtained by CT scan with those obtained by photogrammetry in patients undergoing autogenous fat grafting to the chin., Methods: A prospective longitudinal study was undertaken to assess patients undergoing autologous fat grafting to the chin, capturing preoperative and postoperative (6 months) images with CT scan and photogrammetry. Captured images were submitted to 3D reconstruction with Blender image software., Results: A total of 40 patients were submitted to surgery. Seventy-five percent were female. Median age and BMI were 26.5 years and 23.6 kg/m2, respectively. Median volume of fat grafted was 10 mL (interquartile range 8-12.25 mL). Results showed that the median preoperative volume measured by CT scan was larger than the photogrammetry measurement (12.48 mL vs 12.01 mL, respectively, P < .001). Likewise, a larger volume was measured by CT scan than by photogrammetry (15.54 mL vs 14.94 mL respectively, P < .001) 6 months postoperatively. However, there was no difference between CT scan and photogrammetry measurements of the change in volume from preoperatively to postoperatively (P = .89)., Conclusions: There was no agreement between fat graft volume measurements obtained by 3D photogrammetry and CT scan techniques with regard to absolute values of fat graft volume measurements, however no difference was found between the 2 methods when comparing preoperative with postoperative fat graft volume variation., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Aesthetic Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Brazil has always been a fertile place for plastic surgery techniques, especially cosmetic, and it was not different in rhinoplasty. In Brazil surgeons started using the dorsal preservation rhinoplasty in the 1970s. Techniques have changed, the problems and contraindications were challenged, and solutions proposed. As a result, indications were expanded to almost every kind of nose. Surface working executed with power tools, such as the piezoelectric device and the power drill, complemented the techniques and allowed for refinement in execution. Today the Brazilian preservation techniques are adopted and improved by many surgeons around the world., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Summary: For V-shaped nasal bones, the authors consider that ostectomy of the dorsal keystone area can be avoided, and this has led to the development of a new preservation technique: the spare roof technique B (or Ferreira-Ishida technique), where the bony cap is preserved. It includes six main steps, as follows. Step 1, draw on the surface of the skin the desired dorsal brow-tip aesthetic lines, the pyriform aperture, the rhinion, and the amount of triangular bone that has to be taken out to allow pushing-down the bony cap, and the transversal line in the beginning of the nasal hump. Step 2, release the upper lateral cartilages from the dorsal septum ("high septal strip"). Step 3, take out the amount of dorsal septum necessary to dehump. Step 4, perform the paramedian high parallel osteotomies exactly below the marked brow-tip dorsal aesthetic lines. Then, perform the second group of lower osteotomies, until the E-point, to achieve a triangular shape of bone in each side of the bony cap. Perform the ostectomy of the mentioned triangular areas. Release the lateral keystone area. Perform partial ultrasonic ostectomy endonasally, below the nasal bones, to promote the weakening of the transverse fracture line, in the sagittal plane just above the E-point. Push-down gently the rectangular bony cap with a Luc nasal forceps (19 cm) in a greenstick fashion. Perform lateral traditional osteotomies from high to low to high to narrow the bony bridge as much as is needed. Step 5, perform a regular L-shape Cottle septoplasty (if necessary). Step 6, suture the cartilaginous middle vault (upper lateral cartilages) to the dorsal aspect of the remaining septum., Competing Interests: Disclosure:The authors declare that they have no conflicts of interest to report., (Copyright © 2022 by the American Society of Plastic Surgeons.)